Illinois.  General  Assembly.  Senate. 
-Sel.  Cmte.  upon  the  111.  Retreat  for. 
the  Insane.  Report,  Feb. 6,  1847. 


ILLINOIS  HISTORICAL  SURVEY 


r* 

!'-u'v<)IS  >  SENATE.  <  15th  ASSEM. 

SESSION. 


<  15th  ASSE 
MST  SESSIO 


OF    THE 


SELECT  CO31-MITTEE, 


UPOK    THE 


ILLINOIS  RETREAT  FOR  THE  INSANE,  &c.,  &c. 


FEBRUARY  6,  1847. 
Laid  on  the  table,  and  3,000  copies  ordered  to  bo  printed  for  the  use  of  the  General  Assembly, 


The  Select  Committee  to  whom  \vas  referred  the  bill  to  incorporate  the  Illinois 
Retreat  for  the  Insane,  the  memorial  of  Miss  Dix  on  the  subject  of  the  Insane, 
and  a  number  of  petitions  praying  the  establishment  of  a  State  Hospital  for  the 
Insane,  having  had  the  same  under  consideration,  beg  leave  respectlully  to 

REPORT  : 

From  the  results  of  inquiries  instituted  with  a  view  to  the  ascertainment  of 
facts  on  the  subject  of  Insanity,  your  committee  are  of  opinion,  that  if  there  is 
anyone  class  among  the  proper  objects  of  public  beneficence,  which  at  the  pre- 
sent time  demands  the  enlistment  of  the  warmest  sympathy  and  commisseration 
of  the  Legislature,  more  than  another,  it  is  that  class  of  persons  who  are  bereft 
of  reason. 

According  to  the  census  returns  for  1840,  there  were  at  that  period,  in  the 
western  and  south-western  States,  and  the  territories  o*'  Wisconsin  and  Iowa, 
two  thousand  one.  hundred  and  sixty-seve-i  insane  persons,  exclusive  of  idiots  and 
imbeciles.  The  increase  of  population,  during  the  six  subsequent  years,  togeth- 
er with  the  ordinary  causes  that  give  birth  to  Insanity,  have  great  y  augmented 
this  number.  In  addition  to  this,  the  operation  of  certain  extraordinary  agencies 
that  have  overspread  the  country,  have  exerted  a  deleterious  influence,  so  that  a 
careful  estimate  of  the  actual  number  at  the  present  lime,  in  this  vast  territory, 
has  placed  the  minimum  at  2,500.  This  whole  region  is,  with  the  exception  of 
three  States,  almost  entirely  destitute  of  facilities  for  the  relief  of  this  class  of 
persons.  In  the  States  of  Ohio,  Kentucky  and  Tennessee,  there  are  public 
Asylums  established  by  those  States  respectively,  for*  the  accommodation  of  their 
own  insane  population,  and  supported  it  the  public  expense.  The  original  de- 
sign in  their  establishment  was  chiefly  to  provide  means  of  relief  for  the  indi- 


gent.  Indiana  is  nobly  following  the  example  set,  by  erecting  a  large  edifice 
for  the  care  of  her  insane.  There  is  also  a  small  institution  in  Missouri,  sup- 
ported, as  we  are  informed,  by  private  contribution.  These  institutions,  in  the 
aggregate,  will  afford  accommodations  for  but  little  over  (iOO  patients;  so  that 
there  are  probably  2,000  unfortunate  beings,  in  this  portion  of  the  territory  of 
the  United  States,  suffering  from  mental  derangement,  with  but  very  imperfect 
and  ineffectual  means  of  relief  at  command;  their  friends  compelled,  indeed,  to  re- 
main in  anxious  suspense,  until  a  vacancy  occur  in  some  one  of  those  crowded 
asylums  before  admittance  can  be  gained  for  them;  and,  perhaps,  when  that  time 
arrives,  the  fell  destroyer  has  fastened  himself  immovably  upon  the  brain,  and 
banished  reason  from  her  seat  forever. 

The  State  Institutions  having  been  established  and  endowed  by  the  State  Le- 
gislatures for  the  benefit  of  their  own  citizens,  and  the  accommodations  provided 
being  insufficient  even  for  them,  the  Directors  have  been  compelled  to  refuse  all 
applications  from  other  States.  In  the  Ohio  Asylum  alone,  during  the  seven 
years  that  it  has  been  in  operation,  there  have  been  about  600  applications  re- 
fused for  want  of  room.  During  the  first  six  years,  thirteen  are  mentioned  from 
this  State;  and  many  having  been  informed  of  the  adoption  of  the  rule  above 
stated,  have  never  made  application.  The  eastern  asylums  are  generally  crowd- 
ed, so  that  it  is  seldom  that  opportunity  is  afforded  to  obtain  admission  for  luna- 
tic patients  from  this  State. 

In  relation  to  the  insane  of  this  State,  your  committee  have  been  enabled  to  as- 
certain statistical  and  other  facts  of  great  importance,  from  a  gentleman  who  has 
been  for  some  years  diligently  engaged  in  making  investigations  on  the  subject. 
By  the  statements  thus  furnished,  it  appears  that  the  aggregate  number  of  insane 
persons  in  the  State,  whose  mental  disease  is  of  such  a  character  as  renders  them 
fit  subjects  for  an  Insane  Hospital,  is  upwards  of  300.  By  the  census  of  1840,  it 
appears  that  there  were  at  that  period,  in  the  State,  293  insane  persons  and  idiots. 
Many  inaccuracies  have  been  detected  in  that  report,  the  occurrence  of  which 
was  doubtless  unavoidable.  These,  however,  make  but  little  variation  in  the 
aggregate,  from  the  actual  number.  A  small  portion  of  the  idiots  and  imbeciles 
are  of  that  harmless  and  inoffensive  character,  which  does  not  reouire  their  se- 
clusion in  an  asylum,  as  a  measure  of  public  safety;  and  they  are,  therefore,  not 
included  in  the  estimate  made  of  the  actual  number  existing  at  the  present  time. 
The  following  table  exhibits  the  number  of  those  in  each  county,  for  whose  re- 
covery to  reason,  hospital  care  and  treatment  is  indispensable.  In  most  instances, 
the  numbers  are  given  from  special  returns,  and  in  the  few  remaining  counties, 
in  order  to  make  the  estimate  as  complete  as  possible,  the  census  returns  have 
been  made  the  basis  of  calculation. 


rt 


OM 

TABLE  showing  the  number  of  Lunatics  in  each,  County,  exclusive  of  Idiots,  See. 


Adams, 

2 

Jackson, 

0 

Ogle, 

1 

Bond, 

4 

Jasper, 

2 

Peoria, 

9 

Boone, 

1 

Jefferson, 

4 

Perry, 

2 

Brown, 

3 

Jersey, 

2 

Piatt, 

1 

Bureau, 

1 

Joe  Daviess, 

3 

Pike, 

8 

Calhoun, 

2 

Kane, 

4 

Putnam, 

2 

Cass, 

4 

Kendall, 

3 

Randolph, 

8 

Champaign, 

1 

Knox, 

9 

Rfchland, 

3 

Christian, 

1 

Lake, 

1 

Rock  Island, 

2 

Clay, 

1 

La  Salle, 

3 

Sangamon, 

10 

Clinton, 

4 

Lawrence, 

5 

Schuyler, 

5 

Cook, 

5 

Lee, 

1 

Scott, 

3 

Crawford, 

5 

Logan, 

6 

Shelby, 

7 

De  Kalb, 

3 

Macon, 

3 

Stephenson, 

1 

De  Witt, 

7 

Macoupin, 

7 

St.  Clair, 

4 

Du  Page, 

3 

Madison, 

4 

Tazewell, 

1 

Edgar, 

9 

Marion, 

6 

Union, 

7 

Edwards, 

1 

Marshall, 

1 

Vermillion, 

10 

Effingham, 

2 

Mason, 

1 

Wabash, 

5 

Franklin, 

6 

McHenry, 

1 

Warren, 

6 

Fulton, 

9 

McLean, 

4 

Wayne, 

5 

Gallatin, 

7 

Menard, 

5 

White, 

7 

Greene, 

8 

Mercer, 

2 

Whiteside, 

'2 

Hamilton, 

1 

Monroe, 

3 

Will, 

2 

Hancock, 

4 

Montgomery, 

1 

Williamson, 

4 

Hardin, 

1 

Morgan, 

12 

Winnebago, 

1   ^ 

Iroquois, 

2 

--""TO 

The  condition  in  which  these  poor  sufferers  are  found,  is  in  many  instances 
revolting  to  humanity.  The  want  of  a  suitable  place  of  safety  has  rendered  it 
necessary  for  those  having  charge  of  lunatics  to  resort  to  jails,  prisons  and  dun- 
geons. In  one  instance,  an  insane  man  has  been  confined  in  a  hole  dug  in  the 
ground,  for  the  purpose  of  safe-keeping,  and  to  prevent  him  from  freezing  to 
death.  In  others,  cages  of  logs  have  been  erected  to  prevent  escape.  They 
are  bound  down  with  ropes  and  chains,  the  hands  fastened  together  with  pieces 
of  rope,  and  the  body  fixed  by  another  rope  to  the  wall,  or  floor  of  their  prison- 
house.  Frequently,  they  have  been  kept  nearly  or  entirely  denuded,  and  desti- 
tute of  the  most  common  physical  comforts  of  life.  The  difficulty  and  liability  to 
danger  incurred  by  keeping  fire  in  such  apartments,  and  the  unfaithfulness  of 
keepers,  has  exposed  them  in  inclement  seasons,  to  the  most  extreme  atmos- 
pheric vicissitudes,  until  the  feet  were  so  badly  frozen,  that  they  were  unable  to 
stand.  Similar  instances  of  suffering  are  known,  from  experience,  after  escape 
from  confinement,  presenting  a  melancholy  spectacle,  calculated  to  awaken  the 
deepest  sympathy  in  the  bosom  of  every  true  philanthropist. 

Whether  rich  or  poor,  there  is  comparatively  but  little  variation  in  the  degree 
of  privation  suffered;  for  in  the  one  case,  the  fear  of  personal  danger  apprehend- 
ed by  friends,  together  with  ignorance  of  proper  management,  or  inability  to  pur- 
sue it  when  known,  and,  on  the  other,  a  regard  for  public  safety,  and  a  desire 
to  regulate  the  expenditure  of  public  money  in  the  most  economical  manner, 
causes  the  most  rigid  scrutiny,  and  coercion  to  be  exercised.  Without  refer- 
ence to  the  employment  of  proper  curative  means,  this  vigilance  is  without  judg. 


t- 

or 


•p  31 074 


ment,  palpable  to  the  unfortunate  subject  of  it,  and  seemingly  employed  for  no 
other  purposo  than  to  resist,  in  the  most  obstinate  manner,  every  innocent  desire 
that  may  be  formed.  This  operates  as  a  new  source  of  irritation  to  the  unfortu- 
nate maniac.  He  regards  himself  as  a  persecuted  prisoner;  his  raving  becomes 
•wilder;  he  destroys  his  clothing,  and  every  object  within  his  reach;  utterly  re- 
lusjiig  the  small  moiety  of  comfort  that  may  occasionally  be  extended  to  him; 
until,  in  the  bitterness  of  his  soul,  he  sinks  down  in  despair,  or  becomes  an  un- 
controllable madman.  The  pauper  has,  of  course,  less  of  sympathy  extended  to 
him  than  the  wealthy  lunatic;  and  his  Bufferings,  consequently,  are  in  some  in- 
stances, greatly  augmented.  The  motives  above  mentioned,  being  chiefly  oper- 
ative in  the  minds  of  County  Commissioners,  the  only  oilicial  duty  imposed  is  to 
provide  a  place  of  security,  and  means  to  preserve  animal  existence,  at  the 
cheapest  rate,  in  the  same  way  as  would  be  done  for  a  wild  beast. 

Accumulated  experience  has  established  a  series  of  facts  in  relation  to  In- 
sanity, and  a  series  of  principles  of  treatment  based  thereupon,  which  ought 
to  be  understood  by  every  enlightened  Legislative  body.  Insanity  is  a  phys- 
ical disease,  and  is  subject  to  the  same  laws  in  regard  to  its  progress  which  gov- 
ern other  diseases.  When  the  substance  of  the  brain  is  involved  in  disease,  the 
most  active  means  become  necessary  to  restore  its  functions;  otherwise  an  organ- 
ic change  takes  place,  and  it  can  never  again  resume  its  functions  as  connected 
with  the  operations  of  the  mind.  Growing  out  of  this,  there  is  a  fact  of  the  first 
importance,  which  should  never  be  lost  sight  of.  The  chances  of  cure  diminish  in 
a  rapidly  increasing  ratio,  in  proportion  to  the  duration  of  1he  disease.  The  lon- 
ger it  is  allowed  to  remain  before  suitable  means  are  employed  for  recovery,  the 
more  difficult  it  becomes  to  effect  a  cure;  so  that  cases,  which  in  the  onset  were 
remediable,  will,  after  the  lapse  of  time,  resist  all  efforts  made  for  recovery. — 
Hence  it  is  of  the  greatest  importance,  that  the  disease  should  be  vigorously 
met  as  early  after  the  development  as  possible. 

It  is  confidently  asserted  by  the  highest  medical  authority,  that  acute  mania, 
when  properly  treated,  according  to  the  most  approved  modern  method,  in  its 
earliest  stage,  is  not  more  difficult  of  cure,  and  has  been  cured  in  as  many  in- 
stances out  of  a  given  number,  as  any  other  form  of  severe  acute  disease.  By 
reference  to  the  Reports  of  Lunatic  Hospitals  in  Great  Britain,  France  and  the 
'United  States,  it  will  be  seen  that  the  amount  of  success  obtained  since  the  intro- 
duction of  this  system  of  management,  is,  in  recent  cases,  as  high  as  from  86  to 
'90  per  cent.,  and  in  old  cases,  from  30  to  44  per  cent.  By  recent  cases,  is  meant 
those  whose  insanity  has  commenced  within  one  year  from  the  time  of  their  ad- 
mission into  the  Hospital.  These  results,  however,  cannot  be  obtained  without 
the  employment  of  all  the  curative  influences,  both  moral  and  physical,  which 
can  be  brought  to  bear  in  the  management  of  the  disease. 

The  moral  agencies  made  use  of,  consist  of  the  following  details:  The  early 
removal  of  the  patient  from  the  scenes  and  personal  associations  to  which  he  has 
been  accustomed;  the  careful  exclusion  of  every  thing  of  an  exciting  nature; 
the  classification  of  the  patients  according  to  the  grades  of  their  disease,  each 
class  being  kept  separate  from  the  others;  the  constant  presence  of  a  proper 
number  of  attendants;  uniform  cheerfulness  and  kindness  on  the  part  of  the  su- 
perintendent and  his  subordinates,  religious  worship,  music,  reading, amusements, 
agreeable  company,  and  similar  influences. 

The  physical  a<?ents  embrace  medical  treatment,  bodily  exercise, — such,  for  ex- 
ample, as  a  judicious  system  of  manual  labor, — walking,  riding  in  carriages,  and 
on  horseback,  an  efficient  bathing  establishment,  and  others. 


5 

These  several  appliances  must  be  variously  combined,  and  adapted  to  the 
:<vauts  of  the  different  patients,  according  to  the  variety  of  their  malady.  It  is 
necessary  to  turn  away  the  current  of  hallucination  by  presenting  attractions 
which  are  calculated  to  draw  the  mind  in  a  direction  opposite  to  that  of  the  delu- 
sion. The  melancholy  are  to  be  encouraged  by  lively  scenes  and  agreeable 
company}  the  wayward  to  be  checked  by  jjentle  admonition,  by  a  mild  but  tiig- 
nilied  course  of  action,  and  by  appeals  to  the  small  spark  of  reason.  The  wan- 
dering mind  is  also  to  be  diverted  in  various  other  ways,  by  various  objects 
which  have  a  tendency  to  restore  the  equilibrium  of  mental  action. 

On  reviewing  this  list  of  curative  influences,  it  will  be  obvious  that  it  is  be- 
yo:i  I  the  power  of  any  physician  engaged  in  private  practice,  unless  special  pre- 
paration be  made,  to  treat  successfully  the  diseases  of  the  mind.  Hence  it  is, 
that  some  cf  the  best  physicians  of  our  country  are  utterly  baffled  in  their  efforts 
to  render  relief.  The  insuperable  difficulties  met  with,  are  on  all  hands  ac- 
knowledged. This  being  the  case,  the  friends  of  patients  are  ever  on  the  alert, 
seeking  to  embrace  any  opportunity  that  may  be  afforded  for  the  mitigation  of 
the  malady. 

The  number  of  insane  poor  conslitutes  something  over  25  per  cent,  of  the 
whole  number.  The  great  inconvenience  attending  the  care  of  such  persons, 
rentiers  it  difficult  to  obtain  accommodations  for  them.  While  opportunities  may 
frequently  be  had  for  the  board  of  ordinary  paupers  at  a  cost  of  one  dollar  per 
week,  no  one  is  willing  to  assume  the  care  of  a  lunatic  pauper  for  less  than  three 
times  this  sum.  Not  unfrequently,  the  County  Commissioners  have  been  obliged 
to  pay  at  the  rate  of  $200  per  year,  and  in  some  instances  $1  per  day.  The 
cost  of  support  and  mere  safe-keeping,  thus  becomes  a  heavy  burden  to  the 
counties,  without  any  prospect  of  diminution,  except  an  occasional  cure  which 
may  take  place  spontaneously.  This  leads  us  lo  estimate  the  comparative  ex- 
pense of  their  care  and  management  in  a  public  institution,  with  the  prospect  of 
its  cessation. 

Recent  cases  can  often  be  cured  in  a  very  short  space  of  time,  comparatively 
speaking,  varying  with  the  peculiar  circumstances  attending  them.  The  expense, 
in  a  large,  well  regulated  institution,  will  not  exceed  three  dollars  per  week, 
amounting  in  twelve  months,  in  round  numbers,  to  one  hundred  and  fifty  dol- 
lars. A  more  satisfactory  estimate  may  be  made  by  reference  to  the  actual  ex- 
pense incurred  in  asylums.  The  average  cost  of  cure  in  recent  cases  in  the 
Hospital  at  Worcester,  Massachusetts,  is  $5  4  45.  In  several  institutions,  this 
ranges  from  $35  10  to  $64  05.  Allowing  the  expense  of  supporting  these  pa- 
tients, previous  to  admission,  to  have  been  but  $2  per  week,  which  is  the  very 
lowest  probable  rate,  it  would  in  most  cases  have  amounted  to  $100.  And,  it 
should  be  remembered,  that  the  cures  effected  in  these  cases,  is  nearly,  or  quite, 
nine-tenths  of  all  who  came  under  the  happy  influence  of  the  continued  agencies 
employed.  Without  this,  the  expense  would  not  stop  at  $100,  but  when  the  pe- 
riod of  curability  has  passed,  would  extend  to  thousands,  provided  the  life  of  the 
individual  should  be  spared  for  a  series  of  years.  A  comparison  between  the  ex- 
pense of  supporting  old  cases  out  of  an  asylum,  and  that  incurred  by  a  residence 
in  one  of  those  establishments,  is  equally  striking.  While  there  is  no  probabil- 
ity of  the  expense  diminishing  out  of  an  asylum,  the  proportion  of  cures  efi'ecled 
therein,  is  found  30  to  44  per  cent.,  and  consequently  a  cessation  of  expense  to 
the  public,  in  tha  ratio.  And  even  in  the  very  worst  aspect  in  which  a  case  can 
be  viewed — the  absolutely  incurable — there  is  a  good  relief  afforded  to  the  coun- 
ty authorities,  by  leaving  the  charge  of  the  case  transferred  to  other  and  better 
hands;  no  increase  in  the  expense,  but  in  some  instances,  a  considerable  de- 
crease. And  will  it  be  an  affair  of  minor  consequence  to  know,  that  by  this 
transfer,  the  poor  lunatic  will  be  made,  comparative!)  speaking,  a  happy  man? 


From  these  considerations,  your  committee  would  earnestly  recommend  an 
appropriation  to  be  made  for  the  establishment  of  a  public  Insane  Asylum,  not 
only  as  a  measure  of  State  policy,  by  which  a  sreat  saving  may  be  effected  in 
the  expenditure  of  the  public  funds,  and  as  a  solemn  duty  of  humanity  incum- 
bent upon  the  Legislature;  and  entertaining  these  views,  herewith  report  abitf- 
for  "An  act  to  establish  the  Illinois  State  Hospital  for  the  Insane." 
All  of  which  is  respectfully  submitted. 

CHARLES  H.  CONSTABLE, 

Chairman  Select  Committee. 


